Spine · 2025
Dental Cement Augmentation Increases Pullout Strength With Comparable Removal Torque for Lateral Mass Screws.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Castro Javier, Wadhwa Harsh, Okoli Olivia, Chan Calvin, Ahmad Somayeh H, Karnowska Anna, Hu Serena S, Koltsov Jayme, Bruckman Karl, Mok James M
Аннотация
STUDY DESIGN: Biomechanical/basic science.
OBJECTIVE: To evaluate the efficacy of dental cement augmentation of lateral mass screws in the cervical spine.
SUMMARY OF BACKGROUND DATA: Premature loosening and fixation failure are known problems of screw fixation of the spine, especially in cases of poor bone quality. Cement augmentation of screws with PMMA has limited utility in the cervical spine due to the small size of the bone and high risk of extravasation. Augmentation with dental cement may present a viable solution for posterior cervical spinal screw fixation.
METHODS: Fifteen cadaveric cervical vertebrae were prepared. Lateral mass screw fixation (3.5×12 mm) was performed bilaterally with standard freehand technique by an attending spine surgeon. For augmented screws, dental composite was applied to the screw hole before placement of the screw. Nine vertebrae were used for pullout testing. Screws were attached to a material testing machine and axially loaded until failure. In the remaining 6 vertebrae, peak torque required to remove the screws from the bone was measured via a digital torque driver. A t test was used to analyze the results between the augmented and nonaugmented groups, with significance set to P <0.05.
RESULTS: Augmented lateral mass screws exhibited significantly higher pullout strength (263.8±79.4 N) compared with nonaugmented screws (127.7±21.2 N). ( P =0.0005) There was no significant difference in the mean torque required for screw removal between the augmented (4.20±2.83 lb-in) and nonaugmented groups (4.49±2.09 lb-in) ( P =0.9). The dental composite was radio-opaque and observable on x-ray.
CONCLUSIONS: Augmentation with dental composite enhanced pullout strength without altering the removal torque of cervical lateral mass screws in human bone. Dental cement augmentation of lateral mass screws during subaxial cervical spine fusion may be a safe and effective method of improving fixation strength without affecting ease of revision.
OBJECTIVE: To evaluate the efficacy of dental cement augmentation of lateral mass screws in the cervical spine.
SUMMARY OF BACKGROUND DATA: Premature loosening and fixation failure are known problems of screw fixation of the spine, especially in cases of poor bone quality. Cement augmentation of screws with PMMA has limited utility in the cervical spine due to the small size of the bone and high risk of extravasation. Augmentation with dental cement may present a viable solution for posterior cervical spinal screw fixation.
METHODS: Fifteen cadaveric cervical vertebrae were prepared. Lateral mass screw fixation (3.5×12 mm) was performed bilaterally with standard freehand technique by an attending spine surgeon. For augmented screws, dental composite was applied to the screw hole before placement of the screw. Nine vertebrae were used for pullout testing. Screws were attached to a material testing machine and axially loaded until failure. In the remaining 6 vertebrae, peak torque required to remove the screws from the bone was measured via a digital torque driver. A t test was used to analyze the results between the augmented and nonaugmented groups, with significance set to P <0.05.
RESULTS: Augmented lateral mass screws exhibited significantly higher pullout strength (263.8±79.4 N) compared with nonaugmented screws (127.7±21.2 N). ( P =0.0005) There was no significant difference in the mean torque required for screw removal between the augmented (4.20±2.83 lb-in) and nonaugmented groups (4.49±2.09 lb-in) ( P =0.9). The dental composite was radio-opaque and observable on x-ray.
CONCLUSIONS: Augmentation with dental composite enhanced pullout strength without altering the removal torque of cervical lateral mass screws in human bone. Dental cement augmentation of lateral mass screws during subaxial cervical spine fusion may be a safe and effective method of improving fixation strength without affecting ease of revision.